Efficacy and safety of acupuncture combined with analgesics on lung cancer pain: A protocol for systematic review and meta-analysis

Background:Lung cancer (LC) is the malignant tumor with the highest incidence in the world, and treatment methods include surgery, radiotherapy, chemotherapy, and immunotherapy. Cancer pain is a common symptom in patients with LC, and the clinical treatment is to relieve it with analgesics. Acupuncture can relieve cancer pain. This study aims to systematically study the efficacy and safety of acupuncture combined with analgesics on cancer pain in patients with LC.Methods:From the beginning to April 2021, search Medline, Embase, Cochrane Central Controlled Trials Register (Central), China National Knowledge Infrastructure (CNKI), Wanfang Database, China Biomedical Literature Database (CBM), and Chinese Science Journal Database (VIP database). Search the international clinical trial registration platform and the Chinese clinical trial registration platform to find ongoing or unpublished trials. The main outcome indicator is the total effective rate of analgesia, and the secondary outcome indicator is pain intensity score and adverse reactions. The RevMan 5.4 software will be used for statistical analysis.Results:This study will provide the latest evidence for acupuncture combined with analgesics to relieve LC pain.Conclusion:The conclusion of this study is to evaluate the effectiveness and safety of acupuncture combined with analgesics in alleviating LC pain.INPLASY registration number:INPLASY202150051     

Early prediction of response to neoadjuvant chemotherapy using contrast-enhanced ultrasound in breast cancer

Early prediction of non-response is essential in order to avoid inefficient treatments. The objective of this study was to determine the contrast-enhanced ultrasound (CEUS) for early predicting pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients.Between March 2018 and October 2019, 93 consecutive patients with histologically proven breast cancer scheduled for NAC were enrolled. Conventional ultrasound and CEUS imaging were performed before NAC and after two cycles of NAC. CEUS parameters were compared with pathologic response. Multiple logistic regression analyses were utilized to explore CEUS parameters to predict pCR, and receiver operating characteristic analysis was used to evaluate the predictive ability.Therapeutic response was obtained from 25 (27%) patients with pCR and 68 (73%) with non-pCR. Compared to non-pCR, pCR cases have a significantly higher proportion of homogeneous enhancement feature (56% vs 14%, P < .001) and centripetal enhancement (52% vs 23%, P = .012). A significant decrease in peak intensity (PI) was observed after two cycles of NAC. Compared with non-pCR patients, the kinetic parameters PI change (PI%) was higher in pCR patients (P < .001). Multiple logistic regression demonstrated two independent predictors of pCR: internal homogeneity (odds ratio, 4.85; 95% confidence interval: 1.20–19.65; P = .027) and PI% (odds ratio, 1.08; 95% confidence interval: 1.02–1.15; P = .007). In receiver operating characteristic curve analysis, internal homogeneity and PI%, with area under curve of 0.71 and 0.84, predicted pCR with sensitivity (56%, 95%) and specificity (85%, 70%), respectively.Internal homogeneity and PI% of CEUS may be useful in the noninvasive early prediction of pCR in patients with breast cancer.     

Whether cognitive behavioral therapy is effective for Alzheimer's disease: A protocol for systematic review and network meta-analysis

Background:Alzheimer disease (AD) is a progressive neurodegenerative disease characterized by impaired memory and cognitive judgment. It is the leading cause of dementia in the elderly, and its high morbidity and mortality have also brought a significant social burden. So far, there is no method can completely cure Alzheimer''s dementia, but there are many non-drug treatments that have been praised by people, especially the cognitive behavioral therapy proposed in recent years. The main purpose of this article is to evaluate the effect of cognitive behavioral therapy on the cognitive function improvement of patients with Alzheimer''s dementia.Methods:We did a network meta-analysis to identify both direct and indirect evidence in relevant studies. A systematic literature search will be performed in the Cochrane Library, PubMed, and EMBASE from inception to October 2020. We extracted the relevant information from these trials with a predefined data extraction sheet and assessed the risk of bias with the Cochrane risk of bias tool.The outcomes investigated were Mini–Mental State Examination and AD Assessment Scale-Cognitive section scores. We did a pair-wise meta-analysis using the fixed-effects model and then did a random-effects network meta-analysis within a Bayesian framework. The = the Assessment of Multiple Systematic Reviews-2 scale, Preferred Reporting Items for Systematic Reviews and Meta-Analyses scale and Grading of Recommendations Assessment, Development and Evaluation were used to assess the quality and evidence grade of the literature. General characteristics of the eligible randomized controlled trials will be summarized and described. Meanwhile, The ADDIS software will be used to perform the network meta-analysis, and the result figures will be generated by STATA 15.0 software.Results:Using the draft search strategy of databases and after screening,7 randomized controlled trials met the a priori criteria and were included. This network mate-analysis will be published in a peer-reviewed journal.Conclusion:Our study will provide evidence for cognitive behavioral intervention in AD patients. And provide recommendations and guidelines for the clinic.Protocol Registration:INPLASY2020110052.     

Impact of binocular integrated visual field defects on healthy related quality of life in glaucoma

To investigate the impact of different types of binocular integrated visual field defects on the quality of life in glaucoma.Ninety-six patients with primary glaucoma were divided into 5 groups with 25, 24, 11, 15, and 21 patients according to types of the binocular integrated visual field (BVF) defects. The criteria for BVF grouping included mild visual field defect in binocular eyes, mild visual field defect in 1 eye and moderate or advanced defect in the other, moderate and non-overlapping visual field defect in both eyes, overlapping and moderate visual field defect in binocular eyes, and severe defect in both eyes, respectively. The visual field (VF) evaluation was based on H-P-A visual field grading system. Visual acuity, visual field tests and Glaucoma Quality of Life-15 Questionnaire (GQL-15) were performed for enrolled patients, and binocular visual field results were integrated. The changes and correlations of the Visual field index values and quality of life scores were compared among the 5 groups. The main factors affecting the quality of life in glaucoma were analyzed by multiple regression analysis.The best binocular integrated visual field index (BVFI) and optimal quality of life were observed in group A. The BVFI of group B was better than that of group C or group D, but the peripheral vision glare and dark adaptation were worse. No significant difference was noted between group C and group D in terms of BVFI. However, the glare and dark adaptation in group C were better than that in group D. The BVFI was the lowest and the quality of life was the worst in group E. In all, BVFI and decibels (dB) values were negatively correlated with GQL-15 scores and positively correlated with patients’ quality of life.Binocular integrated visual field accurately reflects the visual function in glaucoma. Higher binocular integrated visual field indices represent a better quality of life for patients with glaucoma. Mild to moderate synchronous or complementary binocular VF defects had a slight effect on the quality of life, while severe and non-compensated VF loss significantly impacts on quality of life in glaucoma patients.     

An integrated pathway interaction network for the combination of four effective compounds from ShengMai preparations in the treatment of cardio-cerebral ischemic diseases

Aim:

SMXZF (a combination of ginsenoside Rb1, ginsenoside Rg1, schizandrin and DT-13) derived from Chinese traditional medicine formula ShengMai preparations) is capable of alleviating cerebral ischemia-reperfusion injury in mice. In this study we used network pharmacology approach to explore the mechanisms of SMXZF in the treatment of cardio-cerebral ischemic diseases.

Methods:

Based upon the chemical predictors, such as chemical structure, pharmacological information and systems biology functional data analysis, a target-pathway interaction network was constructed to identify potential pathways and targets of SMXZF in the treatment of cardio-cerebral ischemia. Furthermore, the most related pathways were verified in TNF-α-treated human vascular endothelial EA.hy926 cells and H2O2-treated rat PC12 cells.

Results:

Three signaling pathways including the NF-κB pathway, oxidative stress pathway and cytokine network pathway were demonstrated to be the main signaling pathways. The results from the gene ontology analysis were in accordance with these signaling pathways. The target proteins were found to be associated with other diseases such as vision, renal and metabolic diseases, although they exerted therapeutic actions on cardio-cerebral ischemic diseases. Furthermore, SMXZF not only dose-dependently inhibited the phosphorylation of NF-κB, p50, p65 and IKKα/β in TNF-α-treated EA.hy926 cells, but also regulated the Nrf2/HO-1 pathway in H2O2-treated PC12 cells.

Conclusion:

NF-κB signaling pathway, oxidative stress pathway and cytokine network pathway are mainly responsible for the therapeutic actions of SMXZF against cardio-cerebral ischemic diseases.     

Prevalence and Risk Factors for Osteopathy in Chronic Pancreatitis

Digestive Diseases and Sciences - The high incidence of osteopathy among patients with chronic pancreatitis (CP) has garnered increased attention over recent years. The aims of this study were to...     

High Diagnostic Accuracy and Safety of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Malignant Lymph Nodes: A Systematic Review and Meta-Analysis

Digestive Diseases and Sciences - Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is increasingly being used for diagnosing lymphadenopathy. We aim to systematically review the...     

A non-invasive model for predicting liver fibrosis in HBeAg-positive patients with normal or slightly elevated alanine aminotransferase

Early and accurate diagnosis of liver fibrosis is necessary for HBeAg-positive chronic hepatitis B (CHB) patients with normal or slightly increased alanine aminotransferase (ALT), Liver biopsy and many non-invasive predicting markers have several application restrictions in grass-roots hospitals. We aimed to construct a non-invasive model based on routinely serum markers to predict liver fibrosis for this population.A total of 363 CHB patients with HBeAg-positive, ALT ≤2-fold the upper limit of normal and liver biopsy data were randomly divided into training (n = 266) and validation groups (n = 97). Two non-invasive models were established based on multivariable logistic regression analysis in the training group. Model 2 with a lower Akaike information criterion (AIC) was selected as a better predictive model. Receiver operating characteristic (ROC) was used to evaluate the model and was then independently validated in the validation group.The formula of Model 2 was logit (Model value) = 5.67+0.08 × Age −2.44 × log10 [the quantification of serum HBsAg (qHBsAg)] −0.60 × log10 [the quantification of serum HBeAg (qHBeAg)]+0.02 × ALT+0.03 ×  aspartate aminotransferase (AST). The area under the ROC curve (AUC) was 0.89 for the training group and 0.86 for the validation group. Using 2 cut-off points of −2.61 and 0.25, 59% of patients could be identified with liver fibrosis and antiviral treatment decisions were made without liver biopsies, and 149 patients were recommended to undergo liver biopsy for accurate diagnosis.In this study, the non-invasive model could predict liver fibrosis and may reduce the need for liver biopsy in HBeAg-positive CHB patients with normal or slightly increased ALT.